The History of Public Health and Community Nursing

Section 1

Lillian Wald is considered to be one of the founders of the American community of nurses. She has made significant contributions to the development of the preparation system for mid-level health workers.

In 1893, she founded a well-known charitable institution Henry Street Settlement in New York’s Lower East Side. Later, she opened a training center for nurses, which focused mainly on the representatives of the poor immigrant families (Lundy & Janes, 2009, p.83). , There were many ill people in East Side, who could not afford decent medical care. Wald could not bear to see the suffering of others, so she helped local poor people by providing them with basic health care for free. In 1893, Lillian Wald also invented the term ‘public health nurse’. It was the name of her counterparts that were actively engaged in the work with the masses (Lundy & Janes, 2009, p. 83).

In 1902, the first nursing service in the USA was established in public schools in New York on Lillian’s initiative. She also participated in the creation of visiting nurses service (Lundy & Janes, 2009, p. 83). Very soon, the service, established by Lillian, outgrew the scope of the district and was transformed into an urban level service. By 1906, 26 employees worked with Lillian; by 1913 this amount constituted 92 people. A number of Wald’s ideas became the basis for the first global project of public health nursing service, established by the New York Board of Health. Later it was Lillian Wald, who became the first president of the National Organization for Public Health Nursing (Lundy & Janes, 2009, p. 83).

Moreover, in 1910, Wald went to the semi-annual trip around the world. Along the way, she visited Hawaii, Japan, China, and Russia, and has played an important role in the development of medical movement at the international level (Lundy & Janes, 2009, p. 83).

Wald was a pacifist, and when the First World War started, she did not hide her anti-war views. But patrons, who invested money in her center, did not like it. Therefore, Wald stopped to express her opinion publically and even helped to prepare front-line nurses in order to have a possibility to help the poor (Lundy & Janes, 2009, p. 84).

She managed to get admission to the City Hall and to convince officials of the need for medical assistance programs, which will be financed by the state. After a while, Wald got positions in several governmental committees, but she did not cease to be engaged in private practice (Lundy & Janes, 2009, p. 84). Being a governmental official, she was helping people in poor neighborhoods as well as spent her salary on medicine and the creation of charitable organizations. Moreover, Lillian Wald wrote two books The House on Henry Street and Windows on Henry Street that is very informative and often quoted (Lundy & Janes, 2009, p. 84).

Section 2

If I were Lillian Wald, my highest priority would be to make the cost of the healthcare lower. In fact, Wald also did it. Health care costs are one of the most important things that determine and affect the health of Americans. Health care costs were always high, both in times of Lillian Wald and nowadays. Therefore, a big part of the nation could not and still cannot afford healthcare. Thus, their health is very poor. It means that by making healthcare more accessible to everyone, it is possible to solve this lasting problem. However, some groups of the population cannot afford health care at any cost. That is why the highest priority is to make medicine free for the poorest people. Lillian Wald also made a significant contribution to this sphere, but it was not her highest priority, so there could be done more. Moreover, if I were Lillian Wald, one of the highest priorities of mine would be to put emphasis on the education of ordinary people in order to teach them personal hygiene, first aid, and disease prevention, as well as basics of taking care of the sick. It would prevent illnesses and their aggravation.

If I were Lillian Wald today, the highest priority would be to make the environment cleaner. Polluted environment, especially air and water, is currently one of the most widely spread reasons for various diseases in the world in general and in the USA in particular. Making efforts to encourage different organizations and institutions to fight against pollution would also positively affect the health of Americans.

Section 3

I live in the state of Florida. Prior to the mid-1800s, Florida was home to Seminole Indians, but several white colonists also found the territory quite favorable for a living (Florida Nursing History Project, n.d.). Many dangerous animals, as well as mosquitoes, which spread yellow fever and malaria, inhabited the state. Thus, the cases of smallpox and hookworm infection occurred frequently, which created chronic health problems for the majority of the population.

In 1861-1865, when America was engaged in the civil war, several battles also happened in Florida, which created the necessity in nursing services and medicine (Florida Nursing History Project, n.d.). After the war, the nation began to understand and to recognize the influence that an organized group of qualified nurses could have on the treatment of the war injuries.

In 1913, Florida passed the Nurse Practice Act that regulates professional training and preparation of nurses at the official level. It happened due to the graduate nurses’ association that was formed in 1912 by the nurses of Jacksonville, who used this new organization to promote the law (Florida Nursing History Project, n.d.). This association developed into the Florida Nurses Association. In 1914, the first public health nurses were employed in Florida in order to cope with the spread of tuberculosis. All this happened several years before American women received the right to vote (Florida Nursing History Project, n.d.).

In the early 20th century, Florida was very segregated racially, and midwives assisted black women in childbirth. In the 1920’s, the government started to fund formal pieces of training of these midwives from the federal budget. Due to this initiative, health nurses were able to receive an appropriate education (Florida Nursing History Project, n.d.).

In the 1940-1950s, health care increasingly began to be provided in the hospitals. Therefore, employment in hospitals became the most common nursing job (Florida Nursing History Project, n.d.). In addition, the development of public health provided nurses with many positions.

In the 1960-1970s, two events in central Florida attracted the world’s attention to the state. First, manned space flights began in Cape Canaveral in 1961 (Florida Nursing History Project, n.d.). Ten years later, Disney World, which served millions of tourists each year, was opened. Even when a state became a tourist attraction, Florida’s healthcare and nursing still did not reach an appropriate level of development. Nursing salaries were reduced, and many hospitals were not racially integrated until the 1960s. A strong public health nursing existed in the state until the 1980s when state budget constraints led to a gradual negative impact on the employment that continues even today (Florida Nursing History Project, n.d.).

Section 4

My faculty members are deeply convinced that nurses consider the lessons of the past, which encourage them to be well-prepared to provide the full range of quality and cost-effective services, needed for the promotion of health throughout the new century. It is especially true after the 11th of September, which made the community and public health nursing become more prepared to the terrorists’ attacks.

However, consensus regarding the basic education and the entry-level of registered nurses has not been achieved. My faculty friends think that the United States of America has to take its nursing workforce into consideration, because the majority of nurses have only a basic education, and the amount of nurses with baccalaureate or higher degrees is very small, as they are convinced that such education is insufficient for meeting the needs of patients. Moreover, the members of my faculty think that the local budgets for public health nursing are reduced too strongly and that the whole system is too financially oriented. Additionally, my faculty members believe that nowadays, there is almost no difference between community health and public health nursing.

Section 5

HandsOn Miami is one of the best, most famous, and popular volunteer agencies in Miami Dade County. Its purpose is to inspire, equip, and mobilize people to take action in order to positively affect changes in Miami-Dade County. HandsOn Miami includes six unique service programs that involve more than 29,000 volunteers and over 1,153 projects on an annual basis (HandsOn Miami, n.d.). These programs include Flexible Program that is called so because it accommodates the schedule of working individuals and students; Community Bridges Program that is organized to enable at least 100 people to volunteer together and to conduct one or two projects per month; Corporate Services that involve the work with corporations in order to provide businesses and their employees with ways of becoming more active in their community; Youth Volunteer Corps that is a youth-volunteering program, offered only to teenagers aged 13 and older; Center on Nonprofit Effectiveness that provides nonprofit organizations in Miami-Dade County with necessary resources, starting from management information to tools, training, and customized services; and Annual Days of Service, which are held four times every year in order to give people an opportunity to make significant investments (Hands On Miami Day, Dr. Martin Luther King, Jr. Day of Service, Global Youth Service Day, and Service Juris) (HandsOn Miami, n.d.). The sources of funding for the organization are ordinary people and such famous sponsors as Hasbro, Target, American Express, University of Phoenix, Ups, Exelis, and others (HandsOn Miami, n.d.).

The recipients of services have a right to use the website of the HandsOn Miami at any time. They are also granted the right of privacy, so that their personal information will be kept private on request. The clients also have the right to receive a copy of the official registration of the organization, as well as to be familiarized with financial information (HandsOn Miami, n.d.).

Section 6

The first nurse, employed in community-oriented nursing, mentioned in the interview that she believed that more education is needed in the area of nursing. She specified that Baccalaureate programs in nursing tend to teach public health nursing and that she perceived her role as more important and responsible, comparing to taking care of a sick person at home. Community-oriented nurses do dressing changes and other similar things, but she is convinced that they also teach patients and their family members how to manage health problems at home. Patients with health problems can be taught these things while staying in a hospital because often they are overwhelmed with what needs to be done at home. These home care nurses will not only teach a patient, for example, with diabetes, how to manage a wound, but will also teach them how to prevent injuries and manage their disease at home. Nurses also help families to use resources. Therefore, their role is very important.

The second interviewed nurse, employed in community-oriented nursing, perceived her role as even more important. She said that she has an access to a statistical database, which includes the results of different surveys. A person, who uses the service, can participate in any number of programs that involve nurses and other team members, who are backed by statistics and research findings. It ensures active community participation in health teaching, disease management, and any other initiatives, designed to address a problem of the community. A person would also get a program evaluation. Moreover, the actions of the nurse will be guided all the way long, starting from the assessment of the disease, through the evaluation of the treatment. Thus, she believes that the community-oriented nurse has much power.

The third interviewed nurse also perceived herself as an important part of the health delivery system.

Section 7

There are near seventeen nursing organizations in Florida. Four organizations that are considered to be the most famous and powerful were chosen to analyze the potential of improving the expertise of nurses, practicing in the community. These organizations include the Florida Nurses Association (FNA), Florida Nursing Students Association (FNSA), Florida State Association of Occupational Health Nurses (FSAOHN), and Florida Association of Directors of Nursing Administration (FADONA).

FNA has more than a centenary history of supporting all spheres of nursing, including education, sponsoring, working on the legislature, and many other things. Additionally, it forms special interest groups, one of which is Faith Community Nursing SIG that works with the faith community (Florida Nurses Association, n.d.).

FNSA unites nursing students of all spheres to help them to prepare for their future career, to influence the educational process, to control legislative activities, and to make difference in the communities (Florida Nursing Students Association, n.d.).

FSAOHN operates more than a half of century already. It advances the profession of occupational and environmental nursing, through establishing strategic relations, ensuring appropriate legislature, etc (FSAOHN, n.d.).

FADONA is a professional association, which represents nursing administrators, and provides its members with opportunities to participate in the local, regional, state, and national levels as well as offers educational forums and scholarships in order to ensure that the residents, patients, and guests, entrusted to its members, receive high-quality care (FADONA, n.d.).

Thus, there are two organizations that have the biggest potential for improving nursing practice in the community of Florida, which are FNA and FNSA. The first one has a great potential, because it is a constituent of ANA, one of the most powerful nursing organizations in the USA, which operates for a very long period of time, works with nurses from any sphere, and has already gained respect. The second one has the potential, because students are a new generation that has much power. Moreover, students, who unite together and have one aim, can achieve many things.

Section 8

The book Flight Nurse about the adventures of Cherry Ames, who is a practicing nurse, tells the story that takes place at the end of World War II. At that time, the profession of a flight nurse arose. The US Army Air Force started the first training program in autumn in 1942, and in 1943, the first class of Army flight nurses graduated (Sundin, 2013). This period is fully described in the book. Cherry Ames completes six weeks of intensive training, which prepares her and other women to fly in winged ambulances to every American battlefront on the globe, to the places where wounded men need their help (Wells, 2008). It was a revolutionary period in nursing history because no physician accompanied the nurse on a plane. It was clearly described in the book.

Section 9

Florence Nightingale had the possibility to make a significant impact on nursing in the United States because she was very strong and courageous as for a woman, as well as very clever, talented, and caring. She also was able to achieve everything because of her persistence and ability to present arguments. Thus, Nightingale reorganized the army medical service and despite of the protests of the War Office, in 1857 managed to establish the Royal Commission on the Health of the Army (BBC, n.d.). Even though at that time women could not be the members of the commission on such levels, Nightingale exerted a strong influence on the activities of the Commission by providing it with much information included in its report. In order to convince the government in the necessity of the reforms, Nightingale provided her own statistical studies, because social statistics was not yet formed (BBC, n.d.).

When Britain and France entered into the war with Russia, Nightingale showed steel endurance, perseverance, and unprecedented efficiency, as well as a natural ability to help people. Florence called herself the main mistress of nursing and a servant for any dirty work. According to the memoirs of the contemporaries, she visited all barracks every night without a fear of contracting an infection (BBC, n.d.). Thus, she gained respect, trust, and recognition in the whole world. Moreover, when she saw the conditions of the hospitals, she was not afraid to write that her commanding officers were not gentlemen, not educated, not businessmen, and had no human feelings. Thus, being afraid to take personal liability, the authority has collected a special fund, due to which, Nightingale was able to organize appropriate nursing care, based on the principles of sanitation, and to teach the whole world how the health care should be provided (BBC, n.d.). Therefore, due to such abilities and characteristics, Florence received an opportunity to make a significant impact on nursing.

Section 10

Being a part of the American Nurses Association, American Nurses Foundation sponsors programs on behalf of the ANA in the form of grants. There is a big amount of sponsored grants in Florida. They include Association of Nurses in AIDS Care, Association of periOperative Registered Nurses, Academy of Neonatal Nursing and the Foundation for Neonatal Research and Education, Margretta Madden Styles Credentialing Research, Southern Nursing Research Society, American Nurses Credentialing Center Clinical Research Grants, Dorothy Cornelius Grant, Virginia Stone Grant, Stryker Medical Research Award, Sayre Memorial Scholar, Jean E. Johnson Grant, and many others. The sponsorship amount varies from $3000 to $30000 (American Nursing Foundation, n.d.). Each program targets different fields of nursing and research. Approximately seven programs are related to community-oriented nurses. They include Sayre Memorial Scholar that considers nurses, which have interactions with patients; Virginia Stone Grant that consider nurses that work in gerontology; Southern Nursing Research Society Grant that has no restriction for the members of the Southern Nursing Research Society, etc (American Nursing Foundation, n.d.).

National League for Nursing also supports and sponsors programs in education in the form of grants. The programs that are supported in Florida include NLN Nursing Education Research Grants that can fund up to $25,000, Mary Anne Rizzolo Doctoral Research Award that funds $2,500, Southern Nursing Research Society/NLN Doctoral Research Award that funds $5,000, and The Sigma Theta Tau International/NLN Research Award that funds $5,000 (National League for Nursing, n.d.). All of the programs are applicable for the community-oriented nurses because of NLN Nursing Education Research Grants and Southern Nursing Research Society/NLN Doctoral Research Award support studies that contribute to the development of nursing education. Other programs support researches for the doctoral dissertations that the community-oriented nurses also write (NLN, n.d.).

Section 11

In Miami Dade County there are near three hundred home health agencies. Most commonly, these home health agencies provide nursing services, home health aides, physical therapy, occupational therapy, and social services (Agency for Health Care Administration, n.d.). Some home health agencies can provide different care, depending on the patient’s needs. They serve all types of patients, from infants to elderly people. However, some agencies can specialize in the specific age groups, such as only kids or only elderly people. The fee for the service is on average $19 per hour plus additional costs. These home health agencies can receive funds in four ways: through Medicare, Medicaid, private insurance companies, or directly from the patients. Approximately forty percent of all home health agencies in Miami Dade County accept Medicare; the other sixty percent receive funds in other ways (Home Health Care Agencies, n.d.).